Thursday, March 30, 2017

From Coalition on Human Needs: We Need a Budget that Works for All

Tell Congress: We Need a Budget that Works for All

How we spend money says a lot about our nation’s priorities. Unfortunately, as you’ve probably heard, President Trump has proposed a budget that would cut human needs to the bone.
Your organization has the ability to help us fight back. By partnering with other groups, we're aiming to collect 100,000 signatures in support of a fair budget. Please Sign and SHARE this petition with your networks.
We need a budget that not just keeps us safe and secure, but also provides opportunities and gives us all the chance to succeed. We need to improve access to healthcare, housing, education, a clean environment, career opportunities, and social services. We need to safeguard vital programs such as SNAP/food stamps, SSI, Social Security, Medicare, and Medicaid, which lift millions out of poverty. We need the economic security that affordable childcare, housing assistance, the Earned Income Tax Credit, and the Child Tax Credit provide. We need to invest in infrastructure, to prevent environmental disasters and protect local communities, and to renew our nation’s railways, roads, bridges, schools, and waterways - the same infrastructure that created so many jobs in the mid-20th century and is now due for repair. We need public works projects that will propel our economy forward, projects that would create hundreds of thousands of jobs in the construction and manufacturing industries.
This petition, which we will present to leaders in Congress, will show that there is widespread support for a fair budget, a People's Budget. Organizations such as yours can make the difference in this campaign, please join us by sharing this petition with your networks.
Thank you,
Deborah, Richelle, Lecia, David, Joe, Melissa, and Leo, and the rest of the folks at CHN.
act now

Wednesday, March 29, 2017

From CFED: Preserve Consumer Protections for Buyers of Manufactured Homes

Act Now to Preserve Consumer Protections for Buyers of Manufactured Homes!

A bill recently introduced in Congress would roll back some basic consumer protections for buyers of manufactured homes. That's right: the Preserving Access to Manufactured Housing Act, H.R. 1699, has been resurrected once again—putting vulnerable homebuyers at risk.

Take action now!

Tell your Representative to oppose the Preserving Access to Manufactured Housing Act. Here's how:
  • Call 202.224.3121 and ask to be connected to your Representative's office. If you don't know who your Representative is, find out here.
  • Once you're connected, here's what to say:
My name is [your name] from [your city and state], and I’m calling to request that you oppose H.R. 1699, the Preserving Access to Manufactured Housing Act. This bill would roll back critical consumer protections for buyers of manufactured homes and would once again expose vulnerable homebuyers to predatory, high-cost loans that put them at risk of losing their homes. 
Why does H.R. 1699 matter? Before the Dodd-Frank Act, chattel lending—which is used to finance most manufactured homes—was largely unregulated. Interest rates on chattel loans were high, as were default ratesDodd-Frank gave the Consumer Financial Protection Bureau (CFPB) authority to regulate chattel loans; now, many of the same laws and regulations that govern mortgage lending also apply to chattel lending. The law already provides a few exemptions for manufactured home dealers and lenders, but H.R. 1699 would harm vulnerable individuals and families by stripping away needed protections.

Find out more about this bill and read the letter that CFED and consumers groups signed in opposition to the 2015 version.

From the CBPP: Trump Budget Would Cut Block Grants Dramatically, Underscoring Danger of Block-Granting Social Programs

MARCH 28, 2017

President Trump’s “skinny” budget would eliminate four discretionary block grants that mainly serve low-income people, and set the stage for substantial cuts to others.  As a result, it would reduce overall funding for block grants for low- and moderate-income people that are “discretionary” (or annually appropriated) programs by half or more just between 2017 and 2018. 
These cuts would come on top of years of deteriorating funding for block grants.  Since 2000, overall funding for block grants targeted on low- and moderate-income people — including both discretionary and mandatory programs — has shrunk by 27 percent in inflation-adjusted terms and 37 percent after accounting for inflation and population growth.  The Trump cuts would sharply exacerbate those declines.
THE PROPOSALS POINT TO A LONGSTANDING INCONSISTENCY BY SOME CONSERVATIVE POLICYMAKERS.  The proposals point to a longstanding inconsistency by some conservative policymakers.  They often argue for creating new block grants to give states needed flexibility to operate programs to best address their needs.  Yet conservatives also often support sharply cutting or eliminating various existing block grants, commonly arguing that the block grants don’t generate evidence of effectiveness.  Such claims are frequently overblown or inaccurate.  At the same time, the very structure of a block grant can make it hard to measure and show effectiveness on a national scale — especially when, as repeatedly occurs, the President and Congress designed the block grant to provide sweeping state or local flexibility to use federal funds and reduce federal accountability over them.
In other words, policymakers sometimes cite the effects of the structural change that they typically advocate when they propose block grants as their reason, in later years, to sharply cut or eliminate those block grants.
The Proposed Cuts
From a list of federal block grants compiled by the Congressional Research Service, we conducted a comprehensive review of funding trends for all federal housing, health, and social services block grants.[1]  Ten of these block grants are funded as discretionary programs, one includes both discretionary and mandatory funds, and two are fully funded as mandatory programs.  (Taken together, a bit more than half of all funding for block grants for low-income people is for mandatory programs.) 
President Trump’s budget would eliminate four of the discretionary block-grant programs: 
·       the Low Income Home Energy Assistance Program (LIHEAP), which helps low-income households — including many poor seniors — pay heating bills (with current funding at $3.4 billion);
·       the Community Development Block Grant (CDBG), which supports housing, community facilities, economic development, and social service projects, mainly for low- and moderate-income residents ($3 billion);
·       the HOME program, which helps develop and preserve affordable rental housing and repair homes of low-income homeowners ($948 million); and
·       the Community Services Block Grant (CSBG), which provides anti-poverty services through local non-profit and public agencies ($714 million).
Eliminating these four block grants would cut overall funding for discretionary block grants by $8.0 billion — or 47 percent — from its $17.2 billion level in 2017.  That 47 percent doesn’t account for inflation or any cuts, rather than outright eliminations, to block-grant programs that may flow from the austere discretionary funding targets that the President has set for most federal departments and agencies.  The Administration won’t release information on most of the President’s cuts to individual programs until it releases his full budget later this spring.
But the “skinny” budget does contain hints of such cuts.  In particular, it calls for a cut in the federal government’s principal job training program, stating that the President’s budget “Decreases Federal support for job training and employment service formula grants”[2] — which make up the job training block grant.  Assuming that this program shrinks by 21 percent, which is the average cut to the Labor Department’s discretionary programs under the “skinny” budget, that raises the President’s overall funding cut to discretionary block-grant programs from $8.0 billion to $8.6 billion, or from 47 percent to 50 percent (see Table 1). 
Lacking more information on the President’s specific program cuts, we haven’t calculated cuts for any other discretionary block grants.  If those block grants are cut at all, the overall cuts in discretionary block grants will climb to more than 50 percent from 2017 to 2018.
Trump Proposal Would Cut Discretionary Block Grants in Half or More
Funding in 2017 (in millions of dollars)
Funding in 2018, under Trump proposal
Temporary Assistance for Needy Families (TANF) block grant

Child Care and Development Fund

Child Care Entitlements to States

Child Care and Development Block Grant
Low Income Home Energy Assistance Program
Community Development Block Grant
Job Training Formula Grants to States (Youth, Adult, and Dislocated Workers)
Substance Abuse Prevention and Treatment Block Grant
Social Services Block Grant

HOME Investment Partnerships Program
Community Services Block Grant
Native American Housing Block Grant
Maternal and Child Health Block Grant
Community Mental Health Services Block Grant
Preventive Health and Health Services Block Grant

Discretionary programs only
Known cut: -$8,616
* Assumes a 21% cut -- the overall percentage cut to discretionary programs under the Labor Department’s jurisdiction.
Note: For discretionary programs, 2017 levels represent annualized funding under the current continuing resolution. 2018 funding levels for mandatory programs – TANF, child care entitlements for states, and the Social Services Block Grant -- are left blank.
Source: CBPP calculations based on data from the Office of Management and Budget and appropriations legislation.

Block grants have already faced substantial cuts in recent years.  Since 2000, overall funding for the 13 major block grants that help low-income people has shrunk by 27 percent after adjusting for inflation (and 37 percent after adjusting for inflation and population growth).[3]  Funding for all but one of these 13 major block grants has fallen, in most cases sharply.

In Figure 1 below, the dotted line shows how the Trump proposal would generate a sharp drop-off, on top of years of funding declines. The drop-off is severe, even though we consider only the explicit cuts to discretionary block grants under the Trump budget, and not the implicit cuts to discretionary block grants or any cuts to block grants funded as mandatory programs.  As noted, most block-grant funding is on the mandatory side, and we won’t know whether the President is seeking cuts in those programs until he releases his full budget in May.  Still, even under the scenario reflected in the graph, overall funding for block-grant programs would be 45 percent lower in 2018 than in 2000 in inflation-adjusted terms, and 53 percent lower after accounting for inflation and population growth.

Figure 1

Overall Funding for Housing, Health, and Human Services Block Grants, Already Low, Would Fall Significantly Under Trump Proposal

 The Longstanding Contradictory Pattern
The Trump proposal reflects a longstanding pattern of inconsistency by some conservative policymakers when it comes to block grants.  They often argue to convert existing programs into block grants largely to give states the necessary flexibility to make the programs work better.  Then, some years later, they or their counterparts argue to cut or eliminate such block grants.  
Frequently, policymakers cite the very flexibility that block grants provide to state and local governments as their reason to cut or end them.  The increased flexibility and diminished accountability over using federal funds that are built into the basic structure of many block grants mean that states can use the funds in highly diffuse ways, making a block grant’s impact much harder to assess.  That, in turn, can eventually prompt federal policymakers who are seeking budget cuts to target block grants and argue that block-grant programs lack sufficient evidence of effectiveness.  In arguing to end funding for such block grants as LIHEAP, CSBG, and CDBG, the Trump budget adopts this line, asserting that their impact is wanting (and ignoring evidence that points in the other direction).
Ironically, while proposing to eliminate these four block grants, the President also proposes to create a new one: a $500 million block grant at the Centers for Disease Control and Prevention that would apparently come from consolidating — and presumably cutting — various categorical grants.  His budget says that would “increase State flexibility and focus on the leading public health challenges specific to each State.”[4]  In addition, the health care legislation that had been advanced by House Republican leaders, with President Trump’s support, included a provision to turn Medicaid into a per capita cap (a structural cousin to a block grant)[5] or, at state option, a block grant for children and some adults.  (This legislation was pulled from consideration on March 24 as it lacked the necessary votes for passage.)
Decades of block-grant funding trends, along with the new Trump proposals to slice discretionary block grants deeply, suggest the likely effect of such changes would be significant funding cuts over time.
End Notes
[1] David Reich, Isaac Shapiro, Chloe Cho, and Richard Kogan, “Block-Granting Low-Income Programs Leads to Large Funding Declines Over Time, History Shows,” CBPP, February 22, 2017,  http://www.cbpp.org/research/federal-budget/block-granting-low-income-programs-leads-to-large-funding-declines-over-time.
[2] Office of Management and Budget, America First:  A Budget Blueprint to Make America Great Again, March 16, 2017, p. 31.
[3] Block grants on both the discretionary and mandatory sides of the budget fell substantially over this period, with the overall funding of discretionary block grants declining by 35 percent after accounting for inflation and population growth, and the overall funding of block grants on the mandatory side declining by 39 percent using this metric.
[4] The Trump Administration’s “skinny” budget does not indicate which existing grants or programs the block grant would replace.
[5] Edwin Park, “Medicaid Per Capita Cap Would Shift Costs and Risks to States and Harm Millions of Beneficiaries,” CBPP, revised February 27, 2017.  http://www.cbpp.org/research/health/medicaid-per-capita-cap-would-shift-costs-and-risks-to-states-and-harm-millions-of.

Wednesday, March 22, 2017

Policy Brief: CFED: Earned Income Tax Credit

Today, CFED is releasing a new policy brief on the Earned Income Tax Credit: Enhancing and Expanding the EITC for Low-Wage Workers. Depending who you talk to in Washington, tax reform is either charging full steam ahead or it’s completely dead. Either way, if Congress and the Trump Administration want to make the tax code work for working people – and not just for corporations and the wealthy – they will focus on turning our upside-down tax code right-side up
You already know that the Earned Income Tax Credit is a right-side up feature of the tax code that is also the most effective anti-poverty tool we have. It has a proven track record, the positive effects of which for children of recipients last well into adulthood, including improved test scores, boosted college enrollment, increased earnings as adults and higher Social Security benefits in retirement. Recently, it was also linked to improved health outcomes.
Congress should build on the success of this critical tool for supporting the opportunity economy. Our brief highlights the opportunities policymakers have to expand the credit: increasing benefits for workers not raising children and creating a Rainy Day EITC program to empower workers to save. It also underscores the EITC is not the main driver of the tax gap, and proposals that make the credit harder to claim or less generous in the name of “fraud reduction” should be rejected. Instead, Congress should simplify the complicated rules to qualify, further study measures to reduce improper payments that are already in place and establish minimum competency standards for paid tax preparers.
Please use this brief as a tool for your advocacy as you meet with federal policymakers. It’s difficult to predict when exactly tax reform might come up on Congress’s agenda, and even harder to predict whether EITC will be in the cross-hairs if it does, but this brief serves as a strong defense for preserving and expanding the EITC.
If you have any questions, please contact Chad Bolt. Thank you for your work to build an opportunity economy for all.


From The Center on Budget and Policy Priorities: Commentary: The House Republican Health Bill – A Test for Members

March 22, 2017
When House GOP leaders unveiled their legislation to repeal the Affordable Care Act (ACA), House Republicans faced a fundamental question: would they insist on changes to make the bill fairer for the tens of millions of low- and moderate-income people across America who would be treated harshly under it?
After all, the Congressional Budget Office (CBO) had estimated that it would cause 24 million Americans to lose health insurance by 2026, cut Medicaid by $880 billion over the decade, cut in half by 2026 the subsidies that help modest-income people afford insurance, and eliminate all of the assistance to help modest-income people with high deductibles and cost-sharing.  Rubbing salt in the wound for low- and moderate-income people, the bill also included $600 billion in tax cuts, the majority of which would go to the top 1 percent of Americans. 
THE BILL WOULD LIKELY REPRESENT THE GREATEST ASSAULT ON MODEST-INCOME AMERICANS OF ANY LAW IN MODERN TIMES.All told, the bill would likely represent both the greatest assault on modest-income Americans of any law in modern times, as well as the largest redistribution from low- and middle-income people to the wealthy in memory.
House leaders promised changes.  But the changes in their updated bill, unveiled the night of March 20, are astounding.  In some cases, they’re minor improvements that leave most of the damage in place.  In other cases, they make the damage more severe.  The number of Americans who would lose coverage won’t likely change much.  Meanwhile, the increases in out-of-pocket costs — especially for near-poor working families, people aged 50-64, and others who live in areas with high health-insurance costs (especially rural states) — would remain very large.  Most shockingly, the biggest winners from these changes are the top 1 percent — the very people who were already the big winners under the previous version of the legislation.
Let’s start with Medicaid.

The Medicaid Revisions

One change in the bill gives states the option to convert their Medicaid programs (except for their elderly and disabled beneficiaries) into a block grant, under which states would get a fixed amount of Medicaid funding for the year that wouldn’t change if a recession hit, a plant closed, more people became poor, an epidemic struck, or anything else happened that raised health costs.  Because a state’s block-grant allocation would rise each year only at the general inflation rate, which is well below the rate at which U.S. health care costs rise, the block grant would necessitate increasingly deep Medicaid cuts over time.  Nor would the block grant funding level adjust for population growth, either.
Why would any state consider this option?  Because the bill dangles an incentive in front of conservative state policymakers:  it allows states that choose the block grant to substantially reduce the amount that states must contribute to get the federal funds.  Governors and legislators who want to fund big tax cuts, or close budget holes, could find that enticing.  Years later, they or their state successors would have to cut Medicaid coverage substantially to fit within the shrunken amount of both federal and state Medicaid dollars.
The revised bill also would let any state impose work requirements on poor adults who aren’t elderly, disabled, or pregnant as a condition of Medicaid coverage — with only narrow exemptions.  Those affected could include a young adult who’s attending community college to gain skills he or she needs to succeed in the marketplace, a married mother who’s caring for an infant, or an adult who’s caring for an infirm or disabled parent rather than institutionalize the parent.  Work requirements also could be imposed on poor individuals who need treatment — for mental health issues or substance abuse — to get or hold a job.  And, states imposing work requirements wouldn’t have to provide job training or other employment services.  The requirement wouldn’t likely mean that many more people would find jobs; instead, its main effect would likely be to leave more people who are poor and vulnerable uninsured.
The revised bill does include one Medicaid improvement.  It would raise by one percentage point the annual adjustment in the “per capita caps” on the federal Medicaid funding that states would get for their elderly and disabled Medicaid caseloads.  But this adjustment wouldn’t start till 2020, and its effects on total state Medicaid funding would be modest.  The federal Medicaid funding cuts — and the cost shifts to states — would remain steep.

Health Coverage in the Private Insurance Market

The revisions for private coverage are also woefully inadequate.  Mainly, the revised bill expands the tax deduction for high medical expenses, which is mainly used by — and of greatest benefit to — the affluent.  Currently, people who itemize deductions can deduct medical expenses that exceed 10 percent of their income.  The earlier version of the bill lowered that threshold to 7.5 percent, which Congress’ Joint Tax Committee found would give almost 70 percent of the resulting tax cuts to those making over $100,000 a year.  The revised bill lowers the threshold further — to 5.8 percent of income — reportedly at a cost of $75 billion or $85 billion over ten years.  Those with six-figure incomes would continue to benefit the most.
Under the bill’s previous version, the more than 10 million people who now buy coverage through the ACA’s marketplaces would see their tax credits cut by an average of more than $2,000, with far larger cuts for those who are older, low income, or live in high-cost states.  The expanded tax deduction in the revised bill would do little or nothing for most people who’d be hurt by shrinking the tax credits.
To be sure, House leaders have indicated flexibility over how to use this $85 billion.  They’ve said the Senate could use it instead to improve the bill’s tax credits for buying coverage.  But the legislation cuts current premium subsidies by $312 billion over ten years and eliminates entirely the ACA’s cost-sharing subsidies.  The $85 billion could address only a small fraction of the large cost increases that these changes would impose on millions of people.
As a result, if all $85 billion were used to raise tax credits for people aged 50-64, while doing nothing for anyone else:
  • Lower-income seniors would still see large increases in net premiums (premiums after tax credits). If all $85 billion went to raise the tax credits for people aged 50-64, tax credits for people age 60 and up would rise by a little over $2,000 by 2026,[1]compared to the previous version of the bill.  CBO calculates that a 64-year-old with income of $26,500 in an area with average premium costs would see her net premium rise by $12,900 under the earlier House bill.  Using all $85 billion to boost the diminished tax credits for people over 50 would close only about one-sixth of the gap — and even less of the gap in high-cost states.
  • Millions of people under age 50 would still see large reductions in tax credits and increases in net premiums, and millions of people of all ages would still see large increases in deductibles, co-pays, and other out-of-pocket costs.  As noted, the House bill eliminates the ACA’s cost-sharing subsidies, which now reduce deductibles, co-pays, and other out-of-pocket costs by an average of more than $1,000 for more than 6 million people with modest incomes.  Moreover, CBO estimates that the House bill would generally lead to an increase in deductibles and co-payment charges even for people who do not get cost-sharing subsidies. Modest tax credit changes would do nothing to address those increases.

More Money to the Most Well-Off

House leaders revised their earlier legislation in one more fundamental way: to hand billions of dollars more to the top 1 percent.  They’ve done so by starting the bill’s large tax cuts — most of which go to the top 1 percent — a year earlier than last week’s bill did, in 2017 rather than 2018.

The Bottom Line

The audacity of this revised legislation is stunning.  It raises the question of whether a majority of our elected representatives will vote to threaten the health care, and thereby worsen the lives, of tens of millions of their constituents.
Will this legislation stir the conscience of House members to think about the tens of millions of low- and moderate-income Americans whose fortunes are at stake?  The coming days will tell.

End Notes

[1] Based on CBO’s estimates, an additional $85 billion would allow a 20-25 percent increase in aggregate tax credit costs under the House bill.  Based on the age distribution of current marketplace consumers, about half of tax credit costs go toward tax credits for people age 50 and older, and so their tax credits could increase by about 45 percent.  CBO estimates that tax credits under the House bill would be worth $4,900 for people age 60 and older in 2026.

Tuesday, March 14, 2017

From Economic Policy Institute: Mass Incarceration Contributes Significantly to Racial Achievement Gap

On Wednesday, March 15th at 10:30 a.m. ET, EPI is presenting a new report that outlines the connections between mass incarceration and racial achievement gaps. As many as one-in-four African American students has a parent who is or has been incarcerated, and the discriminatory incarceration of African American parents has damaging consequences for children in school. Simply put, our criminal justice system makes a significant contribution to the racial achievement gap in both cognitive and non-cognitive skills. EPI research associates Richard Rothstein and Leila Morsy will discuss their new work with Glenn Loury of Brown University and Ames Grawert of the Brennan Center. The Washington Post’s Valerie Strauss will moderate the discussion. The panel will take place at the Economic Policy Institute on Wednesday, March 15th at 10:30 a.m. ET. Wednesday, March 15th at 10:30 a.m. ET Richard Rothstein, Economic Policy Institute Leila Morsy, Economic Policy Institute Glenn Loury, Brown University Ames Grawert, Brennan Center Valerie Strauss, The Washington Post Economic Policy Institute 1225 Eye St. NW, Sixth Floor, Washington, DC 20005 RSVP for this event The event will be streamed at the link below: http://www.epi.org/event/mass-incarceration-contributes-significantly-to-the-racial-achievement-gap/?mc_cid=6a03f82f92&mc_eid=3e33589adc

From Economic Policy Institute (EPI) - Trumpcare: A massive tax cut for the super-rich

Before the Affordable Care Act, over 15% of U.S. residents were uninsured. Today, that number is less than 10%. That’s 19.2 million newly insured individuals between 2010 and 2015, including 2.8 million children. One of the important aspects of the ACA is that it has addressed economic inequality by making wealthy individuals and the health care industry pay their fair share in taxes. And in return we’ve expanded health care to millions of low- and middle-income families. The new Republican plan to replace the ACA―Trumpcare―would reverse the progress we’ve made. According to the new score by the Congressional Budget Office, 14 million people will lose their health care in the first year of Trumpcare with another 10 million losing health care by 2026. That’s 24 million people who will lose health care under Donald Trump. We cannot allow Donald Trump and Congress to roll back critical health care reforms at the expense of seniors, people with disabilities and low- and middle-income families―all for a tax cut for the super-rich. Sign the petition to Congress today and tell them to reject Trumpcare. Additionally, Trumpcare would cut taxes dedicated to finance Medicare by at least $117 billion and cut Medicaid by $370 billion. It uses cuts to Medicaid and reductions in subsidies that help people purchase insurance through exchanges in order to give a $465 billion tax break to the wealthy, health insurance companies and the pharmaceutical industry―including a $7 million annual tax break to the wealthiest 400 U.S. households. Currently, 10 million seniors and people with disabilities receive joint Medicare and Medicaid coverage. Medicaid covers the cost of long-term care for over 60 percent of nursing home patients. Trumpcare’s deep cuts to Medicaid will do more than kick millions off of their health care. It will also jeopardize the long-term care of millions of seniors, forcing families to make tough decisions about how to care for loved ones. Sign the petition today and tell Congres to reject Trumpcare―a bill that cuts Medicaid and guts Medicare’s financial base, kicks millions of low- and middle-income families off of their health care, and provides a massive tax break to the super-rich. Together let’s protect the health care of U.S. families and build an economy that works for everyone, not just the wealthy few. Thank you, Josh Bivens Director of Research, EPI Policy Center

Thursday, March 9, 2017

CFED: The Marriage of Health and Wealth: A Union to Last a Lifetime

Kate Griffin and Parker Cohen on 11/03/2016 @ 11:00 AM

“If you want to lower my blood pressure, help me pay my electricity bill.” These words that frame Jason Purnell’s essay in What It’s Worth capture it perfectly: the connection between health and wealth is inextricable. At CFED’s 2016 Assets Learning Conference, we held a lively concurrent session and an invitation-only discussion with 50 leaders from the health care, public health, community development and asset-building sectors to gain a deeper understanding of this intersection. Judging by both attendance and the enthusiasm of the conversation, we’ve tapped into something important—and we’re excited to share three promising avenues for us to explore as a field.
Prolonged financial stress can cause “toxic stress,” which affects the immune, cardiovascular and nervous systems, and can lead to conditions like high blood pressure and heart disease. Financial stress also forces some households to forgo doctor visits or skip prescriptions. For children, the stakes are even higher—their brains develop differently when they grow up carrying the stressors of poverty.
The “social determinants of health”—which the World Health Organization defines as “the conditions in which people are born, grow, live, work and age”—are “shaped by the distribution of money, power and resources.” While the social determinants of health may be shaped by systems, they impact us as individuals. We must address financial health as a foundational issue to the social determinants of physical health. Based on what we heard at the ALC, we see three opportunities emerging for our field.

Opportunity 1: Expand Service Delivery

How can we build fruitful partnerships with health care providers to jointly deliver services? Just like asset-builders, many in the health care field provide financially vulnerable people with established, trusted community services. For example, Federally Qualified Community Health Centers serve 24 million low-income people annually. Broadly speaking, their mandate is to serve the community’s health needs, and they accomplish this in part by being true community hubs: their staff and boards are composed predominately of community members, and they provide wraparound services and host community events. More about how we might integrate financial capability services into CHCs can be found in our recent policy brief.

Opportunity 2: Broaden Our Coalitions

The U.S. Department of Health and Human Services recently released a new definition of public health. “Public Health 3.0” is the idea that a community public health officer sits at the intersection of each of the systems impacting social determinants of health: business, economic development, housing or criminal justice, to name a few. As such, health policy should be embedded into each sector to ensure equal access to health, not just health care. Public Health 3.0 is a call to expand coalitions, which presents an opportunity for the many asset-building coalitions around the country. Expanding and joining coalitions can help us work together to answer many of these critical questions and forge a path forward.

Opportunity 3: Build Better Systems Together

When people are healthy, our economy benefits. In his What It’s Worth essay, Jason Purnell explains that the most powerful interventions to make people and society healthier involve changing the ways our systems are configured. The Affordable Care Act is a great example of this configuration shift in that it focuses on remunerating health care outcomes, rather than individual services. For instance, if a patient is seen for the same illness multiple times in a month, the health care provider may only be reimbursed once for that expense, thus incentivizing a holistic, preventive approach to health care. These seemingly small intervention can have big effects, as it orients our thinking toward measuring progress in terms of progress toward our ultimate goal: healthier people and healthier communities.
Participants in our ALC sessions dove into these topics by thinking about the other systems-based changes we can leverage to make people healthier. Among the many opportunities raised, they pointed to advocating for systemic change to build a more equitable society and reduce financial stress by bridging the racial wealth divide and turning the tax code right-side up. Although these are no small undertakings, they would go far to improve not only people’s financial health, but also their physical well-being.

The potential for collaboration between the physical and financial well-being sectors is vast. If you’re interested in staying informed on our work in this area, sign up to receive updates here.